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How Long Do COPD Exacerbations Last? Symptoms & Management

COPD exacerbations may last for two days or even two weeks

Chronic obstructive pulmonary disease (COPD) exacerbations may last for two days or even two weeks, depending on the severity of the symptoms. Sometimes, COPD exacerbations may require antibiotics, oral corticosteroids and hospitalization. As your lung function deteriorates in the advanced stages of COPD, exacerbations can increase in frequency and eventually become persistent.

What is a COPD exacerbation?

A COPD exacerbation, or flare-up, occurs when your COPD respiratory symptoms worsen suddenly. You may have trouble breathing, cough and wheeze more than usual and have trouble sleeping. 

Exacerbations are typically caused by a viral or bacterial lung infection, but they can also be triggered by things or situations that cause breathing difficulties, such as: 

  • Smoking
  • Exposure to smoke
  • Air pollution
  • Weather changes
  • Stress or anxiety
  • Overexertion

Frequent flare-ups can eventually lead to: 

  • Declining lung function
  • Poorer quality of life
  • Reduced exercise capacity
  • Increase of airway inflammation

What are the warning signs of a COPD exacerbation?

It’s important to be aware of symptoms of COPD flare-ups so that you can identify them earlier when they are easier to treat. Signs of an oncoming COPD exacerbation include: 

  • Shortness of breath
  • Noisy, wheezy breathing sounds
  • Coughing, sometimes with more mucus than usual
  • Changes in the thickness, color or amount of mucus
  • Inability to take deep breaths
  • Morning headaches
  • Trouble sleeping
  • Feeling tired for more than one day
  • Anxiety
  • Abdominal pain
  • Swelling of the ankles or legs

Some warning signs can be dangerous. Call 911 if you experience the following symptoms:

  • Severe shortness of breath or chest pain
  • Grey or pale skin
  • Blue or purple lips or fingers
  • Confusion
  • Disorientation
  • Trouble speaking in full sentences

How to manage a COPD exacerbation

At the first sign of a flare-up, take the following measures to help manage your symptoms:

  • Avoid panicking.
  • Take medicines as directed. These may include quick-relief inhalers, oral steroids or antibiotics, anti-anxiety medicines or medicine through a nebulizer.
  • Take antibiotics if your physician prescribes them.
  • Use oxygen if prescribed.
  • Breathe slowly. Use pursed lip breathing to save energy.

If your symptoms do not resolve within 48 hours or worsen over time, call your doctor or go to the hospital.

How to prevent a COPD exacerbation

If your COPD exacerbations are frequent, the following methods may help prevent them:

  • Stop smoking and avoid being exposed to smoke.
  • Take medicines as directed.
  • Research exercise, breathing and nutrition tips.
  • Stay away from people with colds and the flu.
  • Wash your hands frequently. Use hand sanitizer if soap and water are not available.
  • Get all recommended vaccines, including flu shots every year.
  • Avoid cold air.
  • Avoid air pollutants, such as fireplace smoke and dust.
  • Try to stay as active as possible.
  • Take breaks throughout the day to give your lungs time to recover between activities.
  • Eat a healthy diet rich in lean proteins, fish, fruit and vegetables.
  • Stay hydrated throughout the day but do not drink liquids with meals. 


COPD Foods to Boost Your Health – COPD Diet Tips
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Medically Reviewed on 5/6/2021


Medline Plus. COPD Flare-Ups.

Donaldson GC, Law M, Kowlessar B, et al. Impact of Prolonged Exacerbation Recovery in Chronic Obstructive Pulmonary Disease. Am J Respir Crit Care Med. 2015;192(8):943-950.

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